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泌尿生殖系统恶性肿瘤患者生存护理计划的接受情况和自我报告健康状况。

Receipt of Survivorship Care Plans and Self-Reported Health Status among Patients with Genitourinary Malignancy.

机构信息

Division of Urology, Maine Medical Center, Portland, Maine.

Tufts University School of Medicine, Boston, Massachusetts.

出版信息

J Urol. 2020 Sep;204(3):564-569. doi: 10.1097/JU.0000000000001032. Epub 2020 Apr 8.

Abstract

PURPOSE

Implementation of survivorship care plans has been emphasized as a key component to improving care for cancer survivors. Our objective was to determine the prevalence of survivorship care plan receipt for survivors of genitourinary malignancy including kidney, prostate and bladder cancer, and evaluate whether receipt was associated with a measurable health benefit.

MATERIALS AND METHODS

Data from the Behavioral Risk Factor Surveillance System Cancer Survivorship modules in 2012, 2014, 2016 and 2017 were analyzed. The proportion of patients with bladder, kidney or prostate cancer receiving a survivorship care plan was calculated. Complex samples multivariable logistic regressions were performed to determine the association of survivorship care plan receipt with sociodemographic variables, and assess the relationship between survivorship care plan receipt and self-reported health status (general, physical and mental).

RESULTS

Survivorship care plan distribution increased from 27.5% in 2012 to 39.5% in 2017. Patients with low income, less formal education and extremes of age were less likely to receive a survivorship care plan. Those receiving a survivorship care plan were less likely to report poor physical health (OR 0.70, CI 0.52-0.96, p=0.026). Subanalysis showed a similar result for physical health of patients with prostate cancer (OR 0.68, CI 0.48-0.96, p=0.030) and general health of patients with kidney cancer (OR 0.37, CI 0.19-0.75, p=0.006).

CONCLUSIONS

Distribution of survivorship care plans to genitourinary malignancy survivors has increased since 2012 in response to advocacy from national organizations. Nonetheless, utilization is low and there is heterogeneity in the populations likely to receive a survivorship care plan. There is a measurable association between survivorship care plans and improved health status but further study is needed to determine causality.

摘要

目的

实施生存护理计划已被强调为改善癌症幸存者护理的关键组成部分。我们的目的是确定泌尿生殖系统恶性肿瘤(包括肾、前列腺和膀胱癌)幸存者接受生存护理计划的比例,并评估接受该计划是否与可衡量的健康益处相关。

材料与方法

分析了 2012 年、2014 年、2016 年和 2017 年行为风险因素监测系统癌症生存模块的数据。计算了接受生存护理计划的膀胱癌、肾癌或前列腺癌患者的比例。采用复杂样本多变量逻辑回归分析来确定生存护理计划接受与社会人口统计学变量的关系,并评估生存护理计划接受与自我报告的健康状况(总体、身体和精神)之间的关系。

结果

生存护理计划的分配比例从 2012 年的 27.5%增加到 2017 年的 39.5%。低收入、受教育程度较低和年龄极端的患者接受生存护理计划的可能性较小。接受生存护理计划的患者报告身体不健康的可能性较低(OR 0.70,CI 0.52-0.96,p=0.026)。亚组分析显示,前列腺癌患者的身体健康(OR 0.68,CI 0.48-0.96,p=0.030)和肾癌患者的总体健康(OR 0.37,CI 0.19-0.75,p=0.006)也有类似的结果。

结论

自 2012 年以来,由于国家组织的倡导,泌尿生殖系统恶性肿瘤幸存者的生存护理计划分配有所增加。然而,利用率仍然较低,而且接受生存护理计划的人群存在异质性。生存护理计划与改善健康状况之间存在可衡量的关联,但需要进一步研究以确定因果关系。

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